Koop Yvonne, Yousif Laura, de Boer Rudolf A, Bots Michiel L, Meijers Wouter C, Vaartjes Ilonca
University Medical Center Utrecht, Julius Centre for Health Sciences and Primary Care, Cardiovascular Epidemiology, Utrecht University, Utrecht, the Netherlands.
Dutch Heart Foundation, The Hague, the Netherlands.
Eur J Clin Invest. 2024 Sep;54(9):e14255. doi: 10.1111/eci.14255. Epub 2024 May 17.
Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Given their high prevalence, it is important to understand the disease burden of cancer mortality in CVD patients.
We aimed to evaluate whether patients with incident CVD have a higher risk of malignancy-related mortality, compared to the general population without CVD.
We performed a national population-based cohort study selecting patients with incident CVD in the Netherlands between 01 April 2000 and 31 December 2005. A reference cohort was selected from the Dutch population using age, sex and ethnicity. Mortality follow-up data were evaluated after data linkage of national registries from Statistics Netherlands until 31 December 2020.
A total of 2,240,879 individuals were selected with a mean follow-up of 12 years (range 0.4-21.0), of which 738,666 patients with incident CVD with a mean age of 71 ± 15 years. Malignancy mortality per 1000 person years was 84 for the reference group and 118 for patients with CVD, with the highest rate of 258 in patients with heart failure. Patients with CVD had a higher malignancy mortality risk, compared to the reference group: HR 1.35 (95%CI 1.33-1.36). Highest risks were observed in patients with venous diseases (HR 2.27, 95%CI 2.17-2.36) and peripheral artery disease (HR 1.87, 95%CI 1.84-2.01).
Results show that CVD predisposes to a higher cancer mortality rate. Of all CVD subtypes, HF patients have the highest cancer mortality rate and the hazards were highest in patients with venous diseases and peripheral artery disease.
心血管疾病（CVD）和癌症是全球两大主要死因。鉴于其高患病率，了解CVD患者中癌症死亡的疾病负担很重要。
我们旨在评估新发CVD患者与无CVD的普通人群相比，是否有更高的恶性肿瘤相关死亡风险。
我们进行了一项基于全国人群的队列研究，选取了2000年4月1日至2005年12月31日期间荷兰的新发CVD患者。使用年龄、性别和种族从荷兰人群中选取一个参考队列。在将荷兰统计局的国家登记数据进行数据链接后，评估直至2020年12月31日的死亡率随访数据。
共选取了2240879人，平均随访12年（范围0.4 - 21.0年），其中738666例新发CVD患者，平均年龄为71±15岁。参考组每1000人年的恶性肿瘤死亡率为84，CVD患者为118，心力衰竭患者的死亡率最高，为258。与参考组相比，CVD患者有更高的恶性肿瘤死亡风险：风险比（HR）为1.35（95%置信区间[CI] 1.33 - 1.36）。静脉疾病患者（HR 2.27，95%CI 2.17 - 2.36）和外周动脉疾病患者（HR 1.87，95%CI 1.84 - 2.01）的风险最高。
结果表明CVD易导致更高的癌症死亡率。在所有CVD亚型中，心力衰竭患者的癌症死亡率最高，静脉疾病和外周动脉疾病患者的风险最高。
